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Correlates and Predictors of Colorectal Cancer Screening among Male Automotive Workers

¹ Center for Health Promotion and Prevention Research and ² Department of Biometry, University of Texas School of Public Health; ³ Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston, Texas; ⁴ Division of Medical Oncology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania; and ⁵ Department of Biometery and Epidemiology, Medical University of South Carolina, Charleston, South Carolina

Requests for reprints: Amy McQueen, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2568, Houston, TX 77030. Phone: 713-500-9782; Fax: 713-500-9750. E-mail: Amy.McQueen{at}uth.tmc.edu

Background: Most studies examining factors associated with colorectal cancer (CRC) screening (CRCS) are cross-sectional and thus temporal relationships cannot be determined. Furthermore, less attention has been paid to psychosocial predictors of CRCS. We examined both cross-sectional correlates of prior CRCS and predictors of prospective CRCS initiation and maintenance during The Next Step Trial, a 2-year worksite behavioral intervention to promote regular CRCS and dietary change.

Method: The sample included 2,693 White male automotive workers at increased occupational risk for, but no history of, CRC who completed a baseline survey. Stratified analyses were conducted for three dependent variables (prior CRCS, CRCS initiation, and CRCS maintenance). We also assessed prior CRCS as a moderator in prospective analyses. Multivariable logistic regression analyses with generalized linear mixed models were used to adjust for cluster sampling.

Results: Except for education, cross-sectional correlates of prior CRCS including older age, family history of CRC or polyps, personal history of polyps, self-efficacy, family support, and intention were also significant prospective predictors of increased CRCS during the trial. Despite differences in the patterns of association for CRCS initiation and maintenance in stratified analyses, the only associations with prospective CRCS that were significantly moderated by prior CRCS were family history and CRCS availability.

Conclusions: Correlates of prior CRCS that also were prospective predictors of CRCS may be suitable targets for intervention. Additionally, intervention messages addressing psychosocial constructs may be relevant for both CRCS initiation and maintenance. However, studies with more diverse samples are needed to replicate the results reported here. (Cancer Epidemiol Biomarkers Prev 2007;16(3):500–9)